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GONORRHOEA

Causative organism Neisseria gonorrhoeae
Incubation period 2-10 days for male urethral infection; occasionallydays to weeks. Most cervical, anal and throat infections are asymptomatic
How far back to trace 2 months
Usual testing method Nucleic acid amplification testing or culture. Where there is an obvious urethral discharge and where possible, a culture would be recommended as an additional test to determine antibiotic sensitivities and resistance.
Common symptoms

Urethral purulent discharge and dysuria in men. Mucopurulent cervicitis / vaginal discharge, pelvic symptoms if PID (see PID)

Scrotal symptoms if epididymo-orchitis (see Epididymitis)

Proctitis — Anorectal pain / purulent discharge in MSM

Gonococcal conjunctivitis — usually presents with an obvious purulent discharge and

may be unilateral or bilateral.

Likelihood of transmission per act of unprotected intercourse 20% for insertive partner; 50% for receptive partner
Likelihood of long-term sexual partner being infected > 50 %
Protective effect of condoms High
Transmission by oral sex Significant
Duration of potential infectivity Up to 12 months
Important sequelae

PID

Epididymo-orchitis; Disseminated gonococcal infection; Neonatal ophthalmia; Enhanced HIV transmission

Direct benefit of detection and treatment of contacts Cure
Usual management of contacts

Counselling, clinical examination and testing of appropriate sites (urethra, cervix, pharynx, anus)(Presumptively treat partners)
There is potential high resistance to other antibiotics, so alternatives are not recommended except in rare cases where an individual has had an allergy to the recommended treatment.

Contact tracing priority High
Notification Notifiable by doctors in all Australian states and territories. Not notifiable in NZ, but voluntary laboratory notification occurs from most regions

 

 

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